Medical Case Manager
Not Disclosed•Full-TimeHybrid
location_onColumbia Place, Dutch Neck, West Windsor, Mercer County, New Jersey, 08550, United States
About the Role
We are seeking a dedicated RN Case Manager to join our team in the New Jersey region. This role is designed for a nurse with a passion for case management who thrives in a hybrid environment, balancing remote work with local field travel. You will play a pivotal part in delivering cost-effective medical case management services that align with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines.
In this position, you will support patients and employees receiving benefits across various insurance lines, including Workers' Compensation, Group Health, Liability, Disability, and Care Management. Your work will directly impact the community by facilitating timely return-to-work solutions and ensuring high-quality care for injured workers and disabled individuals. This is an opportunity to grow your career, earn competitive rewards, and enjoy a true work-life balance while making a meaningful difference.
Location & Work Model
Candidates must be based in one of the following New Jersey areas: Wayne, Clifton, Jersey City, Hoboken, or Newark. This role offers a flexible work-from-home model complemented by local field travel. Approximately 70% of your work time may involve traveling to homes, healthcare providers, job sites, and various offices to facilitate case resolution and return-to-work initiatives. A valid driver's license in your state of residence is required.
Benefits & Growth
We are committed to supporting your professional development and work-life balance. We offer competitive salary commensurate with experience, quarterly bonus opportunities, and free Continuing Education Units (CEUs) for licenses and certificates. Additionally, we provide license and certification reimbursement to help you maintain your credentials and advance your career.
How to Apply
If you are an RN with a passion for case management ready to make an impact, we encourage you to apply today. Please ensure you meet the location requirements and possess the necessary licensure to begin your journey with us.
Work location
Work model: Hybrid
Columbia Place, Dutch Neck, West Windsor, Mercer County, New Jersey, 08550, United States
West Windsor, New Jersey
Key Responsibilities
- check_circleCoordinate timely return-to-work dates with injured workers, employers, and physicians
- check_circlePerform job site evaluations and summaries to facilitate the case management process
- check_circleUtilize clinical expertise to interpret medical records and test results for accurate assessment
- check_circleMeet monthly production and quality assessment requirements to ensure a quality product
- check_circleReview cases with supervisors monthly to evaluate files and obtain directions
- check_circleObtain medical records and diagnostic films to facilitate peer reviews and independent medical exams
- check_circleReview case records and reports to evaluate medical status and identify obstacles to resolution
- check_circleRender opinions on case costs, treatment plans, and outcomes to facilitate return-to-work goals
- check_circleMaintain contact with claims adjusters to apprise them of case activity and secure authorizations
Requirements
- verifiedAssociate's degree or relevant course work/certification in Nursing required; BSN preferred
- verifiedMinimum of 1-3 years diverse clinical experience
- verifiedActive RN home state licensure in good standing
- verifiedValid driver's license in state of residence
- verifiedMinimum of 1 National Certification (CCM, CDMS, CRRN, COHN) preferred
- verifiedMust be compliant with state requirements regarding national certifications
- verifiedMust plan to take certification exam within 36 months if not attained
- verifiedWorking knowledge of Microsoft Office and Lotus Notes
Nice to Have
BSN Degree. National Certification (CCM, CRC, COHN, CRRN). Workers' Comp Case Management experience. Certification as a case manager from the URAC-approved list of certifications.
Benefits & Perks
check_circleQuarterly bonus opportunitiescheck_circleFree CEUs for licenses and certificatescheck_circleLicense and certification reimbursement
Similar Job Opportunities
Skills, education and keywords
Skills: RN, CCM, CRC, Cohn, CRRN, CDMS, Workers' Compensation, Case Management, Urac, Cmsa Standards Of Practice.
Education: Associate's degree or relevant coursework/certification in Nursing required.
Frequently asked questions about Medical Case Manager at Crawford & Company
What does a Medical Case Manager at Crawford & Company do?expand_more
In this Medical Case Manager at Crawford & Company role, you will coordinate timely return-to-work dates with injured workers, employers, and physicians; perform job site evaluations and summaries to facilitate the case management process; utilize clinical expertise to interpret medical records and test results for accurate assessment; and meet monthly production and quality assessment requirements to ensure a quality product.
What are the requirements for this Medical Case Manager role?expand_more
To qualify for the Medical Case Manager at Crawford & Company position, applicants should have: Associate's degree or relevant course work/certification in Nursing required; BSN preferred; Minimum of 1-3 years diverse clinical experience; Active RN home state licensure in good standing; Valid driver's license in state of residence; Minimum of 1 National Certification (CCM, CDMS, CRRN, COHN) preferred; and Must be compliant with state requirements regarding national certifications.
Where is the Medical Case Manager role at Crawford & Company located?expand_more
Medical Case Manager at Crawford & Company is based in Columbia Place, Dutch Neck, West Windsor, Mercer County, New Jersey, 08550, United States. This is a hybrid role.
Is this Medical Case Manager job remote, hybrid, or on-site?expand_more
Crawford & Company has listed this Medical Case Manager role as hybrid.
How much experience is required for this Medical Case Manager role?expand_more
Medical Case Manager at Crawford & Company typically requires 1–3 years of relevant experience at the mid level level.
What skills do you need for the Medical Case Manager role at Crawford & Company?expand_more
Key skills for Medical Case Manager at Crawford & Company include RN; CCM; CRC; Cohn; CRRN; CDMS; Workers' Compensation; and Case Management.
What education is required for Medical Case Manager at Crawford & Company?expand_more
Educational requirements for this role: Associate's degree or relevant coursework/certification in Nursing required.
What category does the Medical Case Manager role belong to?expand_more
Medical Case Manager at Crawford & Company is part of the healthcare & nursing job category on Recrutus.
About Crawford & Company
Crawford & Company is a major entity in the insurance sector, headquartered in Peachtree Corners, Georgia. The firm operates as an independent provider of claims management and outsourcing solutions for insurance carriers, brokers, and corporate clients. Its operations extend globally, maintaining a network that serves customers across more than 70 countries.
The organization is publicly listed on the New York Stock Exchange, trading under the symbols CRD-A and CRD-B. It delivers specialized services designed to support the complex needs of the insurance industry on an international scale. Crawford & Company focuses on providing strategic management and operational support to help partners navigate claims processes efficiently.
Browse more roles: All Crawford & Company jobs, healthcare & nursing jobs on Recrutus.